Visual field defects in optic neuritis and anterior ischemic optic neuropathy: distinctive features

Abstract

A sctoma centered on the fixation point with a sloping border is highly characteristic of ON, while an inferior altitudinal defect with a sharp border along the horizontal meridian, particularly in the nasal periphery, is highly characteristic of AION. To identify these diagnostic criteria, it can be necessary to examine full fields. With restriction of perimetry to 30 degrees a large central scotoma can be mistaken for a diffuse defect and the border in the nasal periphery can be missed.

The investigation of acute optic neuritis: a review and proposed protocol

“…106 Of note, however, this feature has only been reported in 2% of cases, 107 and becomes even rarer (0.5%) later in the disease course. Most patients experience a more generalized reduction in their visual field sensitivity (66%).…”

Posterior ischaemic optic neuropathy: clinical features, pathogenesis, and management

“…Nonarteritic PION was seen in 17 women and 11 men (nine right, 12 left, and seven both eyes), arteritic PION in 10 women and two men (three right, seven left, and two both eyes), and surgical PION in 2 women and one man (one right, one left, and one both eyes). Age range was 20-90 (median 61.5, interquartile [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70] …”

Clinical assessment of optic nerve disorders

“…40 Clinical assessment is subject to observer experience and bias, and pupil perimetry suffers from variations in the subject's level of arousal. However, there is reasonable correlation between the magnitude of the relative 69,74 (ii) Papilloedema (iii) Glaucoma (iv) Optic nerve head drusen (d) Upper temporal field loss not respecting vertical meridian (i) Tilted optic discs (e) Nasal field loss respecting vertical meridian (i) Intracranial optic nerve compression 75 (ii) Primary empty sella syndrome 76 (f) Junctional scotoma of Traquair (unilateral temporal paracentral hemianopic scotoma) F prechiasmatic optic nerve 77 (g) 'Junctional scotoma' (central scotoma with contralateral superotemporal depression) F prechiasmatic optic nerve 78 2. Diffuse (a) Generalised depression (b) Generalised constriction afferent pupillary defect and visual field loss, and hence estimated retinal ganglion cell loss, [41][42][43][44][45][46] but with differences in the slope of the regression line between types of optic neuropathy, suggesting a differential effect on retinal ganglion cells subserving luminance and pupil responses.…”